A group of pro-life leaders is calling on the Trump administration to finalize a rule that would require abortion to be billed separately from other services in taxpayer funded health insurance plans.

An Oct. 21 letter to Seema Verma, administrator of the Centers for Medicare and Medicaid Services at the Department of Health and Human Services, applauded the pro-life efforts of the Trump administration.

The letter asked HHS to further these efforts by implementing a rule removing the ability for insurance companies to create "hidden abortion surcharges," through which "enrollees...are unknowingly paying into plans that subsidize elective abortion."

The letter was signed by the heads of more than 40 pro-life organizations in the U.S., including Susan B. Anthony List, National Right to Life Committee, March for Life Action, Americans United for Life, and American Association of Pro-Life OB-GYNS.

"Since 1976, the Hyde Amendment has prohibited federal funding through Health and Human Services to cover elective abortions or insurance plans that include elective abortion coverage," the signatories said. "Research shows that by the end of 2018, over 2.3 million babies have been saved as a result of this amendment."

However, while the Hyde Amendment applies to federal health care programs including Medicaid, pro-life advocates have voiced concern for years that the Affordable Care Act does not follow its requirements.

Section 1303 of the Affordable Care Act mandates that if a qualified health plan covers elective abortions, it must do so by collecting a payment separate from the standard premium, and depositing that payment into a separate account.

Critics have long argued that enforcement regulations under the Obama era were so permissive as to render the rules meaningless. The regulations allow for health insurers to collect an abortion surcharge without separately identifying it on monthly invoices or collecting it separately.

This essentially renders the surcharge invisible, critics have said. A Government Accountability Office report in 2014 found that many insurers were ignoring Section 1303's requirements.

In their recent letter, the pro-life leaders called for clear and transparent policies requiring a truly separate payment and adequate enforcement measures for abortion coverage in taxpayer-funded insurance plans.

"While including abortion at all in government subsidized health insurance plans runs afoul of the long-standing principle of the Hyde Amendment, requiring separate payments is an important first step in correcting this wrong and providing transparency," they said.

The pro-life advocates reiterated their support for the HHS proposal, "Patient Protection and Affordable Care Act; Exchange Program Integrity," announced last November to explicitly require that abortion be billed separately from other services in taxpayer funded insurance plans.

"As we near the one year anniversary of the proposal of this rule, we strongly urge its finalization and swift implementation," they said.